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Category Archives for Natural Birth

Dates for easier labor

Can Eating Dates Make Labor Easier?

Dates Make Labor Easier? Who Knew?


AKA- Can eating dates make labor easier or will they just jack up my blood sugar and make my baby and me gain excess weight?


Every single pregnant woman on the planet has probably had thoughts about how to have a shorter, easier labor. Recently, info has been circulating again regarding the study saying that dates make labor easier.

Heres the scoop.

This promising info is based on a ????small study that was done in 2008 with 114 women divided into two groups. One group ate 6 dates a day in the last 4 weeks of pregnancy and the other didnt. They were similar in all other major aspects. The outcomes were significant. Of those who consumed the dates the study found:


  • They had significantly more dilation progress when admitted in labor than the non-consuming women.

  • Spontaneous labor occurred in 96% of the date eaters vs. only 79% in the non date eaters.

  • Pitocin induction rates were significantly lower in the date eaters (28%) vs. the non date eaters (47%).

  • The first stage of labor on average was only 8.5 hours in the date eaters vs. 15 hours on average in the non date eaters.

So those stats look really good, right?

I always ask my clients to weigh interventions (yes...eating dates for a perceived benefit can be called an intervention:) on a risks vs. benefits scale. So what could be the downside to all this optimism?

Sugar!

We know that women who consume lots of simple carbs and sugar in pregnancy grow bigger babies which can contribute to all kinds of bad things like...


  • Carb-babies grow big and dont fit through the pelvis as well.

  • Sugar addicted babies sometimes have difficulty regulating their own insulin after birth causing the need for a bunch of heel sticks to check then correct their glucose levels.

  • Then theres the dreaded Gestational Diabetes and all of the interventions and general messing with that go with that high risk diagnosis.

So what about the sugar content in dates?

If you look at the nutritional profile of a date, they look more like a sugar bomb than a healthy snack so..


Let me start with a little blurb about nutrition...specifically protein and how it affects your glucose levels. Growing the right size baby for your body is one of the best things you can do to keep your birth normal.


For the purpose of this short blog post, Im going to really simplify the way your body processes its 3 main fuel sources, Protein, Carbs and Fat.


In a nutshell, you ALWAYS need protein. Eat some at every meal and every snack. Protein is the primary building block you need to grow your baby. Proteins are things like meats, cheeses, beans, quinoa, eggs, fish, nuts and nut butters, hummus, etc.


However, you need other macro-nutrients as well which are carbs and fats.


Ill touch on fat next. The main point I want to get across regarding fats is that good fats do NOT make you fat! They grow your babys brain and are a clean-burning fuel source for your body. They help you feel full longer and offer all kinds of benefits to your heart, brain, mood, joints and skin.


Good fats are things such as grass fed butter, olive oil, coconut oil, avocados, walnuts, small fatty fish like sardines, mackerel, anchovies, (wild caught) salmon, and herring, just to name a few. Heres some great info on fats.

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And then theres the carb lineup.

Carbs get such a bad rap that its important to separate out the good from the bad.


Good (whole) carbs that you want to be eating are things like veggies, oatmeal, ezekiel breads, sweet potatoes, quinoa and other whole grains. OH and DATES!


The risk of dates raising your blood sugar is significantly reduced due to their high fiber content. Fiber slows absorption of the date sugar and protects your blood glucose levels much like protein consumption helps protect your blood sugar levels. The effects of daily date consumption and its effects on blood sugar levels is referenced in another small study.

To reduce that risk even further, just eat a bit of protein with your dates to slow their sugar release into your bloodstream.

Alternately, bad carbs...the ones that will help you grow an 11 pound baby..ugh...are things like fast foods, sugary foods, white breads, white rice, white potatoes and fries, anything with white flour in it, not-so-healthy breakfast cereals, bars and bagels and the like.

Dont do it!! Just say no! Seriously, youll thank me after your birth.

The simple key to growing the right size baby for your body is eating whole foods 95% of the time and combining them correctly.


Strive for one of these 2 options at each meal.


1. Eat protein at every meal and snack (I know, now Im nagging), coupled with a whole carb.

Almonds and dates anyone? How about a smoothie?

Enter your text here...


OR


2. Eat protein at every meal and snack coupled with a good fat.

This sounds like a juicy steak and pile of broccoli with cheese or grass fed butter!

Combinations to avoid

Unless you are purposely trying to put on extra weight, combining fats and carbs together in the same meal is a bad idea.


They collide!


Carbs and fats are basically 2 different sources of energy and when eaten together, one will be used and one will be stored. Your body cant burn both at the same time and most women dont need extra pregnancy weight.


That said, for the rare woman who is having a hard time gaining weight, the collision of fats and carbs, coupled with good protein, is exactly her solution and can help her gain enough weight to support a healthy pregnancy.


You can find much more detail on healthy pregnancy eating at TrimHealthyMama.com, including a lot of really yummy recipes for clean eating.


So back to dates

dates make labor easier

Other Health Benefits of Dates

Aside from the "dates make labor easier" camp, there are so many resources out there talking about the many benefits of eating dates that I wont try to reinvent that wheel. Dates will feed you and your baby some amazing nutrients! Here are the cliff notes according to the website Organic Facts.


Dates are a good source of various vitamins and minerals. Its a good source of energy, sugar and fiber. Essential minerals such as calcium, iron, phosphorus, sodium, potassium, magnesium and zinc are found in dates. It also contains vitamins such as thiamin, riboflavin, niacin, folate, vitamin A and vitamin K.


Here are a few more posts talking about all the benefits of dates.


http://www.onegreenplanet.org/natural-health/dares-and-your-health-the-ideal-food/


http://naturalsociety.com/health-benefits-of-dates-7-reasons-eat-date-fruit/

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Just a few more (VERY IMPORTANT) things that you can do to have a strong pregnancy and easier labor and birth.

As a midwife in SC, Ive seen some amazingly strong women grow incredibly healthy babies by just doing a few things that Ive listed below.


I strongly encourage you to take control over the things that are within your control.


These basic tenets of the Midwife Model of Care are the foundation that will support you and help keep all your options open.


  • Excellent Nutrition

  • Whole Food-based Vitamins

  • Exercise Regularly (walks 3-4 times a week is perfect)

  • Take a Great Childbirth Education Series

  • Know and Practice Optimal Fetal Positioning

  • Hire a Midwife or Doula

And if the study holds true... eat up because dates make labor easier!


When youve been a great steward of your pregnancy, the reward of experiencing your own strength in giving birth is invigorating!!


Girl power!!!

Love and birth joy! Lisa

How about you? Did you eat 6 dates a day in late pregnancy? Do you think that dates make labor easier?

Here are a few keepin it real anecdotal responses I received on my facebook groups. Be sure to add yours below.

>I did and had a great labor, pushed about 30 minutes...no perineum tearing. Sarah M.


>Just had my third, didn't eat any for the first or second pregnancies. Third I at 6 every day. Water broke naturally (not with the first two) and I had a kick ass labor! Amy G.


>I did. I ate them like mad because they were delicious with my last.. even though I started eating them because of their supposed labor help. My dilation was never checked. My water broke as he was crowning. Labor was right around 6 hours, I suppose. I didn't feel a need to call and let my midwife know it was the real deal until about 3 hours into it. Transition and pushing were about 2-5 minutes (but that was pretty much the case with all three of my homebirths). Tia W.


>I did with first baby. He still went to 41 weeks. I was 4cm from 37 weeks til the morning I was induced. Labor was 4 hours, but all of my labors have been 4-5 hours with or without having eaten dates. Sarah R.


>I did! Labor 8 hrs, kind of an arom at around 5 hrs? I think. I'm not sure how dilated I was when midwife arrived, but I had been 5 cm. So when she checked me I said don't tell me unless it's greater, and she said nothing, so I assume 5cm. Nancy A.


>(midwife) never checked me to say how much I was dilated, but my water broke at 9:22pm and she came out at 1:22pm. First baby. And I believe (midwife) showed up around 2ish and I was already in active labor. Joanna B.


>I did. Still went to 42 weeks, still had 18 hours of unproductive labor that en??ded with a 3rd section :-/ not the story you're looking for, but there's always an exception to every rule. Kristyn L.


>I did! I ate 4-6 dates/day during the last trimester of my third pregnancy. My first two labors were pretty long but my third labor had some prodromal stuff and then maybe 60 minutes of active labor, so....antidotal? Lol. Brittany H.


>I did! I ate 6ish a day during the last few months. I had an awesome natural birth on our due date. But i was also drinking raspberry leaf tea, taking evening primrose and I saw an acupuncturist the week prior. Kristen B.

Sources:

http://www.ncbi.nlm.nih.gov/pubmed/21280989

http://www.ncbi.nlm.nih.gov/pubmed/22214443

http://www.ncbi.nlm.nih.gov/pubmed/19681613

http://www.helpguide.org/articles/healthy-eating/choosing-healthy-fats.htm

https://www.organicfacts.net/health-benefits/fruit/health-benefits-of-dates.html

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Turning a Breech Baby

How-to Guide for Turning a Breech Baby

a Midwife's Guide to Turning a Breech Baby


One of the most frustrating things in pregnancy is to get to the end and be told that your baby is in a breech position and that, if she doesn't turn, you'll be scheduled for a c-section. There are many things that you can do to increase your likelihood of turning a breech baby. I'm really glad to be able to share those techniques with you here.

?Let's start with prevention

There are some things that you can do in pregnancy to give your baby the opportunity to get into a great position. What we are aiming for is Optimal Fetal Positioning.

Two birth workers, Jean Sutton and Pauline Scott coined the term, "Optimal Fetal Positioning", or OFP for short.  OFP is traditional birth wisdom, passed from senior midwives to younger midwives and then later recorded in old textbooks. It is the belief that in most cases, the babys position at the beginning of labor predicts the way the birth will unfold.

If I could only teach one thing in pregnancy, it would be Optimal Fetal Positioning. It is THAT important!

Turning a breech baby

?There are entire books and websites dedicated to the subject of optimal fetal positioning. One resource that you'll appreciate knowing about is midwife, Gail Tully's website, Spinning Babies. Gail goes into great detail about belly mapping and exercises to keep your baby in a great position for birth.

Since prevention of poorly positioned babies isn't the focus of this post, I'll just hit the highlights of optimal fetal positioning.

Ideally, your baby will do the best and your labor will be the most straightforward when the back of your baby's head is between your left hip and your belly button.

This position is called LOA which stands for Left Occiput Anterior. Keep in mind, while this is ideal, babies sometimes choose a ROA or right occiput anterior position due to mom's anatomy and still do fine in labor. The challenge with ROA is that is it MUCH easier for a baby to slip into a posterior, or face up position.

The goal is to prevent posterior and breech babies.

Start paying attention to your baby's position by about 32-34 weeks, while the baby is still small enough to easily move.

Here are your optimal fetal positioning basics:

  • Don't recline!!  This is such an important piece of information. If you'd like to relax in later pregnancy, find yourself a birth ball and lean forward onto it or grab a pillow to support your belly and just lay down on your left side. Reclining is THE number one reason for posterior and breech babies and these positions are the number one reason for c-sections.
  • Always sit with your knees lower than your hips. For this to happen, you have to get a bit unladylike and spread those legs, letting your belly hang low. Now is not the time to be prim and proper and cross your legs. That will do nothing to help your baby's position and will restrict your circulation.
  • Practice leaning forward as often as possible. A baby's ideal position is facing towards your back. Think about gravity. It pulls the heaviest part so leaning forward pulls the baby's back towards your belly. Alternately consider, if you are leaning backwards or reclining, that cute little smooshy face is being pressed into your spine. It's kind of like laying in a hammock on your face. NOT comfortable at all and that, alone, makes a baby want to move away from an ideal position.
  • Lastly, drink at least 2 liters of water every day! Babies always do better when their amniotic fluid is normal and drinking water directly affects your amniotic fluid.  If you are forgetting to drink enough water, your amniotic fluid index (afi) falls even further than it normally does in late pregnancy. This puts baby in a dangerous situation because it's much more difficult to move and get off her cord and hard to get into a good position. Drinking enough water is protective on many levels!

You will be urinating much more in late pregnancy so it's important to replace that with good hydration. If you notice that it's more like..water in/water out, add a pinch of sea salt to your water. This small amount of healthy sodium will help your body keep that fluid in your system.

Once you learn the skill of belly mapping, you will be well equipped to ?prevent a persistent posterior or breech position.

15 Techniques for Turning a Breech Baby

  1. Homeopathic Pulsatilla, 200c under tongue every few days while using other positioning techniques for turning a breech baby.
  2. Pelvic Rocking, 5 minutes in the morning before getting out of bed and 5 minutes in the evening before laying down in bed. You can do more at other times during the day. In a hands and knees position or leaning on a birth ball, tuck tailbone under like a scared dog then torque the pelvic bones to aim the tailbone at the ceiling. Do not sag and arch your back. It's ALL about the pelvis.
  3. Elephant walk on your hands and feet. It feels awkward...even hard to do but is amazing at moving baby out of bad positions and into good ones.
  4. Drink LOTS of water!  2 liters to a gallon a day to give baby lots of ability to move.
  5. Have a Webster trained chiropractor perform the Webster Breech Turning Technique. Chiropractors are very helpful in turning a breech baby.
  6. After wading into a warm pool, dive to the bottom. Repeat several times to deweight the baby and allow her to turn. Can also turn somersaults underwater.
  7. Use a bag of frozen peas over the baby's head. They really dislike this and if they can turn, they often do to get away from the cold. Peppermint essential oil can work in a similar fashion when rubbed over the abdomen near baby's head.
  8. Accupuncture can work wonders for turning a breech baby. Like chiropractic, you will keep going until your baby turns.
  9. Visualize baby in a head down position. It may be helpful to place pictures of head down babies all around the house.
  10. Have Papa talk to baby low on the abdomen. Sometimes music placed low, near the pubic bone or lower will also entice baby to turn.
  11. Do handstands or walk on your hands in a warm pool. Again, the idea is to deweight and dislodge the baby so she can turn.
  12. Talk to your baby and ask her to trust you and turn. Reassure her that it will be alright and that you will keep her safe.
  13. Use an ironing board as a slant board by putting one end on the sofa and the other end on the floor. Lay on your back with your head lower than your feet several times a day.  This position works well for turning a breech baby, coupled with the frozen peas on baby's head.
  14. Use a bright flashlight and draw it down from the rib cage to the pubic bone asking baby to follow the light. Okay...hokey but some say it works.
  15. Consider consulting an OB about performing an External Cephalic Version, often just called a "version." This can be done with or without uterine relaxing drugs and always with an ultrasound. It's not the most comfortable but I've seen many successful versions done without drugs. It is typically the last technique to consider before scheduling a c-section but keep in mind that most physicians don't like to perform this too late in the pregnancy because of lower fluid levels and the increasing size of the baby. Ideally, turning a breech baby using a version would be done right around 37 weeks.

Don't underestimate the value of talking to your baby, telling her to turn and visualizing that process. You may want to consider doing some hypnobabies or hypnobirth fear release techinques if you are anxious.

I've seen many of these techniques work for turning a breech baby as long as the position is caught early enough in pregnancy. Take heart mama!

I pray peace and blessings over you as your baby responds to your loving intention.

xoxo, Lisa

Reclaiming Birth

Who Controls Your Birth? The power of Reclaiming Birth


I was completely inspired by a recent article in Pathways to Family Wellness, the magazine you often find in chiropractic offices. The topic of reclaiming birth was powerfully written in this piece.


The fall 2015 cover grabbed me with this title. You're Not Allowed to Not Allow Me: Reclaim the Power of Birth written by birth advocate and Vice President of ImprovingBirth.org, Cristen Pascucci. What a profound title!


Cristen's voice is that of a true protector of normal birth and she highlights a foundational problem in the current maternity care system in the US.


A problem of ownership.


Who owns your birth? For that matter, who owns your health?


Who has the most to gain and the most to lose besides the birthing woman? Who, above all else, has the baby's best interest at heart besides her mother?


Even in 2015, I hear care providers, family members and even the pregnant woman, herself, use the word allow in conjunction with basic human rights. Rights such as holding your baby immediately after birth.


The word, allowing implies power and who rightly holds the power over your body, pregnancy, birth and baby except you?


When a well-meaning provider makes a controlling statement such as, we don't allow eating or drinking in labor or we can't allow you to walk around in labor after your water is broken, a birthing woman often mistakenly assumes that these statements are based on medical facts. Often, that opinion is purely a practice-style or a hospital policy. It's definitely not based in evidence or even best practice guidelines.


In medicine, It's generally known that it takes anywhere from 10-20 years for practitioners to fully adopt changes, based on evidence resulting from studies.

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Old habits die hard, and beyond that, hospital policies are not primarily set up to support the evidence. Instead, hospitals are set up as businesses with a business focus.


You are a consumer and should be treated as a partner in your care, not a ward of the system. Imagine for a minute, your partner not allowing you to do something.

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What the ??


In a relationship, we would think of this as control and abuse, yet we blindly accept this language as the way things are in the "medical model" of maternity care.


Ms. Pascucci references the 2014, American College of Obstetrics and Gynecologys (ACOG) and the Society for Maternal Fetal Medicine's (MFM) Guidelines for lowering the primary c-section rate.

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A statement, on these guidelines, was recently made on NPR which said, Women with low risk pregnancies should be allowed to spend more time in labor, to reduce the risk of having an unnecessary c-section, the nation's obstetricians say.


She also references a segment on CBS News, Philadelphia, in which a spokesperson said, That may mean that we allow a patient to labor longer, to push for a longer amount of time, and to allow patients to take more time through the natural process.


As a South Carolina midwife who practices the midwive's model of care, these words are, on one hand, a welcomed relief. They confirming what midwives already know. On the other hand, they are quite maddening for the reasons of control mentioned above.

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Here's why.?


Midwives primarily trust and support the physiological process of birth as it unfolds. We begin with very important conversations with our clients early on, in your prenatal care. We teach you what it means to take responsibility for your health.  We offer information on nutrition, exercise and lifestyle choices so you can will make a significant difference in keeping your pregnancy low risk.


You don't just roll out of bed one morning and decide to go run a marathon! You train for it. You give your body every opportunity to succeed. Birth is the same.


The midwive's model of care empowers you by sharing all of your options with you.

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Most women, when offered education and understanding on the benefits, risks and alternatives of their choices, will make the absolute, best decisions for themselves and their unborn baby.


Allowing women more time in labor and birth is great but it's really only one piece of the care that women deserve.

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To be truly empowered in Reclaiming Birth, you must come to the understanding that every choice you make up until that birth, will have the potential to affect your birth.


This piece of the message from ACOG and the Society of MFM is missing.


As the article goes on,  it discusses the fact that the national c-section rate is still climbing and that many hospital's in the US have effectively banned vaginal birth after cesarean (VBAC). 

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In essence, they've made policies that do not allow women to birth vaginally, even if that's their decision.



One out of every three women who walk through the doors of a US hospital will end up with major abdominal surgery to birth their child. In some hospitals, that statistic is much higher. Some as high as 70%!


Many of these c-sections would not have become medically necessary if women were able to make true informed choices based on the evidence currently available and given prevention-based care and education.


Again! Are we teaching women how to stay low risk, become aware of how their positioning affects their baby's position and offering trust their body's ability to birth or are we still setting them up for the repeat cesarean based on old school thinking and practice? The medical model of maternity care has dropped this ball mainly due to a well founded fear of liability.


True informed consent or, alternately, informed refusal is a legal and ethical standard. You are given the details of procedures and interventions and also given the ability to accept the medical advice and procedure or to refuse it without stern lectures or fear tactics.

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It is not ethical or fair to pull the "bad mom" card just because your decision may not agree with a doctor's opinion.

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 When a true medical emergency exists, I have not encountered even one mom who would refuse medical intervention.


The ACOG statement regarding informed consent in maternity care says, The freedom to accept or refuse recommended medical treatment has legal as well as ethical foundations. In the obstetric setting, recognize that a competent pregnant woman is the appropriate decision maker for the fetus that she is carrying.


Can I get an AMEN!!??


This statement is completely opposite to the common "medical model" mindset of being allowed to (insert your pleasure) or not allowed to decline potential, harmful interventions and treatments such as surgical birth.

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As one example, the old diagnosis, "failure to progress" (which is the number one reason for unplanned c-sections) has finally met the evidence which makes that diagnosis, more accurately, "failure to wait."?

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Or how about this one? "Once a c-section, always a c-section" or the now infamous VBAC bans? Again, I encourage you to check the facts. 


I invite you to check out the Pathways article referenced above as Ms. Pascucci has some great action points to implement.  We will all need to work together to change the dysfunction in the birthing culture, towards a more woman-centered model.


Here are a few more tools for changing the birth culture, beginning with your birth! You have the right to complete information as you choose your care provider, your place of birth and each and every procedure that is offered.


Speak up for your own birthing rights and Reclaim your birth!


Start before your maternity care begins by doing some preconception through birth planning. Here are some ideas to get you started:


  1. The terrain that you plant your baby in is very important. Make sure your internal bio-terrain (your body) is in great health by focusing on nutrition, environmental factors, excellent supplementation, exercise and stress reduction to stay low risk.

  2. Choose your care provider wisely. Interview people! You are the consumer and in the driver's seat. Whether you choose a medical model or midwifery model care provider, make sure you communicate your preferences and ideals and ask for their help to get what you need. Their language will tell you a LOT!

  3. Don't fall into the eating for two trap of poor eating. Make 95% of your diet intentional, healthful and life giving.

  4. Read and make an intentional plan for your birth. Tell your care provider about the things that are the most important to you and again, ask for their help to get what you need from your birth.

  5. Don't fall into the induction trap. Read, do your research and understand that a failed induction equals a c-section! Avoid that first one by knowing how to stay low risk. There are very few legitimate induction exceptions.

  6. It's ALWAYS about weighing benefits vs. risks. Use this simple acronym to make sure you always have the ability to make informed choices or informed refusals on any intervention being offered.

Use Your Reclaiming Birth B-R-A-I-N

      1. B- Benefits. What are the benefits of the intervention being offered?

      2. R- Risks. What are the risks of the intervention being offered?

      3. A- Alternatives. Are there alternatives to the intervention?

      4. I- Intuition. What does your gut or your intuition say?

      5. N- Nothing. What would happen if you chose to do nothing?

And remember! In most situations in labor, you can ask your care provider to step out of the room so you and your partner can discuss things in private after you've had a chance to gather the facts.

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In my experience, women are most interested in the health of their babies, BUT they are also very interested in their birth experience and how that experience will affect their bonding, their long term mental health and their relationship with their child, forever.

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Some very insensitive practitioners have tried to hold on to the "power grab" by discounting a women's innate need to have their best birth "experience." This is sometimes done by ridiculing a woman's desire for a beautiful birth and playing that "bad mom" card if one desires more than the standard birthing fare.

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Don't settle!? Many women are finding their voice and reclaiming birth.

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If you encounter this type of care, I don't care how far along you are, Seriously consider switching providers.

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Most women will give birth only a handful of times in their lives and you deserve to have competent yet respectful care.

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Find someone who can offer you the care you need, so you can trust that they will support you in birth, the way you deserve.


In the end, everyone's goal is a healthy mama and a healthy baby. However, in this day and age of liability driven birth care, the responsibility falls squarely on you. Know your provider options and the benefits and the risks of your choices to get the best outcome for you and your baby. 

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xoxo, Lisa

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homebirth SC

Homebirth and Birth Centers in SC Under Attack Again

This Affects EVERY Birthing woman.

Home Birth, Birth Center or Hospital!


Today, our guest blogger, Nicole Lavallee, midwife and birth protector shares some compelling reasons why you may want to be involved in protecting birth choices in South Carolina.

The Price of Apathy

Nicole Lavallee LM, CPM, LMT

No one came. No one came to express how important womens childbirth choices are to them. DHEC (the Department of Health and Environmental Control) invited us to a meeting- a workshop- to help shape the new birth center regulations.

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DSC_1698
Stakeholders the invitation letter said. Who is the most important stakeholder in the childbirth choice game? The midwife who makes her living catching babies? Well, if she is like me , she has plenty of other potential income sources. So, no, not her. The doctor, who is absolutely certain that these women are crazy to be choosing something as dangerous as out-of-hospital birth, and feels the need to regulate it to death, and, oh, by the way, it doesnt hurt his bottom-line either? He still has plenty of consumers who have blind faith in what he is selling. So, no, not him.

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The most important stakeholder in the childbirth choice game is the consumer. Because there are really only two ways to become a parent- which the majority of us do, sooner or later. And if you choose to grow that little person that makes you a parent in your body, it has to come out- one way or another. And even if you adopt that little person- his/her birth matters to him/her, and therefore to you. Really.

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DSC_9192
OK- in all honesty, six people did come to the meeting- besides the seven DHEC employees (yes, they had us outnumbered)- the four state birth center owners, the lawyer of one of the birth centers, and me, a homebirth midwife and childbirth activist. I had spent a good bit of energy trying to rally consumers to show up, and based on some of the feedback on social media, at least a few people would be there. Nope. Not a soul. The most important stakeholder, the consumer, was absent.

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On some level, I dont care. At 48, the chances of me having to personally navigate another pregnancy and birth are slim. And even if I were pregnant, and The Man had limited the options of the general public, I am very well connected (and possess a proven pelvis!). I could easily find someone to catch my baby at my birthplace of choice- which is not a birth center. Can you say the same? If you or your daughter or your best friend wanted an out-of-hospital birth, and the laws hindered her/you, is there anyone who would risk breaking the law for her/you?

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You might say, Wait a minute. Im confused. I thought you said it was a meeting about birth centers. But now youre talking about homebirths.

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Read on.

You might say, It doesnt matter to me, I was happy with my natural hospital births. Good for you. Im glad. Did you realize that one of the reasons that unmedicated hospital births are even a thing is because of decades of women fighting for womens rights in childbirth, for women to have a choice to birth where and with whom they chose?

Or you might say, I have homebirths. No sweat off my back if the birth centers close. If I am not having my baby at home, then I am on my way to the hospital, because my midwife told me we needed to go in. As a midwife, I could say that, too. I mean, I dont own a birth center. I could even think to myself, because it would be un-PC to say it out loud, Sure! Let the birth centers close. All the more business for me!

But that would be ignoring the fact that the medical establishment has an agenda. Not just in this state. It is a national agenda. It is an agenda to close birth centers that they do not control. It is an agenda to end homebirths with CPMs. And if they succeed in closing the independent birth centers in this state, it is encouragement for them to keep pushing until the LMs- the homebirth practitioners- are phased out too.

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But, again, why should we care?

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Robbie Davis Floyd discusses in Birth as an American Rite of Passage, the extremes on the continuum help to define the norm in a society. Homebirths and birth center births help to encourage hospitals to practice more evidence-based medicine. They encourage them to listen more closely to consumers. Because they have competition- they have serious financial incentive to step up. When they dont have competition, they dont have to step up.

Did you know that hospital Cesarean rates go up to almost 70% in the United States, and there are many, many places where women are "not allowed" to have a vaginal birth??

As I write that, I say to myself, How is that even possible? But it is. And it didnt happen overnight. It happened a step at a time. Womens rights and choices being slowly eroded until, voila!, they dont have any.

You might say, Well, you have to go to a meeting like that, you are protecting your livelihood. And my reply is, you may think I am so passionate about womens rights and the quickly eroding rights of out-of-hospital birthers in this state because I am a midwife. But you would be wrong. I am a midwife because I care so much about the rights and health of women and babies, and I know that what I do makes a difference. Not just in that pregnancy, or that birth, but in the REST OF THEIR LIVES. I go to these meetings not to save my job, but to better mankind. (Hokey, huh?)

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I get it. The issues are complicated. The language of the various bills and regulations is hard for me to understand sometimes- and I am pretty well-versed in it. But that is all the more reason to come to meetings, ask questions, get educated. But most importantly, come to the meetings to show the powers-that-be that you care. That you are watching them. That you expect them to make choices in the wording of your states laws and regulations that expand rather than limit womens choices.

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Did you know that the members of the DHEC Board who get to give the thumbs up or down to the regulations are not elected? They are appointed. By our governor, Nikki Haley. So if the AMA, who is a generous campaign contributor, says, Nikki, tell that Board of yours how dangerous it is for us not to control all the births in this state, what do you think is going to happen? Unless she thinks it will cost her votes- now or in the future.

I was at a DHEC Board meeting a few months ago where they were discussing the birth center regulations. One of the members was insisting that the language needed to be more restrictive. One of the board members spoke up. Do we really want to get those women riled up again? He was referring to the uproar that ensued when DHEC tried to shut down the birth centers in November of 2013, right around Thanksgiving. I mean, what normal person wants to be getting called away from the Thanksgiving dinner table to discuss birth? Not the Board- so they definitely remembered that week and all those unhappy birth consumers.

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This. This is what grassroots effort is all about. The people making noise. Disturbing the comfort zone, the business-as-usual attitude of the powers-that-be. But it only works as long as they know we will keep coming back again and again.

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National expert in grassroots birth battles, Katie Prown, has taught me a lot about what has worked in other states to gain or maintain birthing choices, and what hasnt. And the main thing that works is massive public outcry against unfair or restrictive birth practices. And to remember that while money talks, votes, or rather potential votes, of lack thereof, speak louder.

But I dont really have time for that, you say. I dont have time to write letters, or go to meetings or rallies. I have ____________________ (a job/three little kids/a sick grandmother/a life). And I say, We all have the same amount of time. You may be choosing to do other things. They may even be really important things. Just dont be surprised when you wake up some day, and dont have the choices you think you deserve.

As one of the leaders of that grassroots movement, Im here to tell you, we (myself and the other leaders) are constantly saying to ourselves, Should we ask them (the consumers) to write a letter now? Or wait? Well, if we ask them to come to this meeting or write this letter, then we cant count on them to be available next month when we really need them. We dont want to burn them out. Newsflash- in this day and age, telling The Man that we wont put up with His foolishness is a never ending process! Let me tell you in a way every mom will understand. This is like changing dirty diapers. There is always going to be another one. And the consequences for not changing it and changing it promptly can be overwhelming. And painful.

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Question- if there was a mom who was hoping or maybe even struggling to avoid an unnecessary c-section, how far would you go to help her? Would you give her physical and emotional support? The same type of support that many of you reading this article had- or wished you had had- in labor? How many hours would you be willing to spend? Now say that woman is your daughter? Your friend? Would you spend more time? Effort? Money?

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If the system is allowed to further restrict the practices of the natural birth practitioners in this state, there will be many more women struggling to avoid unnecessary interventions- many of which lead to unnecessary surgery, unsuccessful breastfeeding, feelings of inadequacy, increase in postpartum depression. Some that lead to death. No one is in a position to help all those women individually, but we can help them to avoid ending up in that situation by improving birth choices and the safety of birth across the board.

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Over the years I have gotten many calls from women, some of whom I have to tell something such as, Im sorry, you have no choices. DHEC put out a memo saying that we cant attend out-of-hospital VBACS. Some of these women have lashed out at me, saying, Why arent the midwives doing something to change that? And I get off the phone and think- you have no idea how much effort I have put into saving VBACs. You also have no idea how many women I have hung in there with in labor- far beyond what most practitioners would consider reasonable- so they wouldnt have to face the VBAC fight with her next pregnancy.

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I cannot tell The Man what you want. You have to tell him what you want. And keep telling Him. Again and again and again.

Nicole Lavallee is a Certified Professional Midwife, and Licensed Massage Therapist who is trying hard to fight the good fight and encourage others to do the same. You can find more info on her homebirth practice in Columbia, SC by going to her website at www.threeriversbirthservices.com

Lisa's note:  I'd love to hear your feedback on this article and ideas for protecting birth centers and home birth in South Carolina and ultimately throughout the United States. Other states are watching and will use what we experience as precedence for their own state's midwifery laws and regulations.

If we don't come up with some really great solutions, our daughters may have no choices at all!

***Stay abreast of current action steps and urgent needs at our SC National Association of Certified Professional Midwives (NACPM) Facebook page HERE.**